KNOW THE FIELD
|Year : 2020 | Volume
| Issue : 2 | Page : 395-396
Floret-like giant cells in intra-osseous schwannoma
Sudeendra Prabhu1, Roshan Athikari1, Maji Jose1, Mohitha Shetty2
1 Department of Oral Pathology, Yenepoya Dental College, Yenepoya Deemed to be University, Mangalore, Karnataka, India
2 Arogya Multispeciality Dental Clinic, Moodbidri, Mangalore, Karnataka, India
|Date of Submission||16-Apr-2020|
|Date of Decision||09-Jul-2020|
|Date of Acceptance||21-Jul-2020|
|Date of Web Publication||09-Sep-2020|
Department of Oral Pathology, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Floret-like giant cells are very commonly seen in neurofibroma and as an indication to be associated with neurofibromatosis type 1 gene. This particular case of intraosseous schwannoma of mandible showing such giant cells, which is rarely reported.
Keywords: Floret, giant cells, neurofibroma, schwannoma
|How to cite this article:|
Prabhu S, Athikari R, Jose M, Shetty M. Floret-like giant cells in intra-osseous schwannoma. J Oral Maxillofac Pathol 2020;24:395-6
|How to cite this URL:|
Prabhu S, Athikari R, Jose M, Shetty M. Floret-like giant cells in intra-osseous schwannoma. J Oral Maxillofac Pathol [serial online] 2020 [cited 2020 Sep 30];24:395-6. Available from: http://www.jomfp.in/text.asp?2020/24/2/395/294608
Schwannoma is a slow-growing benign neoplasm derived from Schwann cells, which are sheath cells that cover myelinated nerve fibers. The soft tissue of the head-and-neck region is one of the most common sites for benign nerve sheath tumors. Intra-osseous occurrence is very rare. This is a case of intraosseous schwannoma [Figure 1] of the mandible, with typical Antoni-A type of histopathological pattern [Figure 2], with floret-like giant cells [Figure 3].
|Figure 1: Well-defined radiolucent lesion in the lower left region of mandible|
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|Figure 2: Spindle cells arranged in a palisading manner around the verocay bodies|
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|Figure 3: Floret-like giant cells with nuclei arranged in a wreath like manner|
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Floret-like giant cells are typical multinucleated cells with nuclei arranged in a wreath like or linear pattern. These are reported to be seen in neurofibromas (sporadic), neurofibromas with neurofibromatosis type 1(NF-1), pleomorphic lipoma, giant cell collagenoma, giant cell fibroblastoma, solitary fibrous tumor and gynecomastia. Immunohistochemically, these cells are positive for vimentin and CD-34 but negative for S-100 and CD68.,
It is commonly associated with neurofibroma, that to neurofibroma with NF-1. A retrospective study by Taungjaruwinai and Goldberg et al. found out that the presence of floret-like giant cells in neurofibromas might be a clue to the presence of NF-1. However, the results of a study by Magro et al. showed that there is no statistically significant correlation between the presence of these cells and neurofibromas with NF-1, as many cases of sporadic neurofibroma, also showed similar cells. They concluded that these giant cells most likely representing a morphological reactive change of the indigenous dermal/endoneurial fibroblasts or dendritic cells in response to unknown micro-environmental stimuli.
A thorough search of English language literature showed no case report of schwannoma with floret-like giant cells. Here, the lesion is solitary and intraosseous, which is showing typical features of schwannoma. The patient is not having any features of NF-1.
We wanted to highlight this case report to emphasize the presence of such giant cells in schwannoma (which is not reported earlier), and also to look for the presence of floret-like giant cells in cases of schwannoma retrospectively.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Zainab H, Kale AD, Hallikermath S. Intraosseous schwannoma of the mandible. J Oral Max Pathol. 2012;16:294-6.
Taungjaruwinai WM, Goldberg LJ. Multinucleate giant cells in neurofibromas: A clue to the diagnosis of neurofibromatosis. J Cutan Pathol 2009;36:1164-7.
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Stanger K, De Kerviler S, Vajtai I, Constantinescu M. The riddle of multinucleated “floret-like” giant cells and their detection in an extensive gluteal neurofibroma: A case report. J Med Case Rep 2013;7:189.
Magro G, Amico P, Vecchio GM, Caltabiano R, Castaing M, Kacerovska D, et al
. Multinucleated floret-like giant cells in sporadic and NF1-associated neurofibromas: A clinicopathologic study of 94 cases. Virchows Arch 2010;456:71-6.
[Figure 1], [Figure 2], [Figure 3]